Liver CA Flashcards
How many forms of Liver Ca is there? Which is more common and why?
Two: primary and secondary form
Secondary form is more common b/c liver is large and richly vascularized (need blood circulation to spread and large space to grow)
Where is the CA in primary form?
CA is first formed in the liver
What is a secondary site? Most common sec sites?
CA is formed in another area of body and spread to liver.
Common sites: liver, lungs, bones, and brain
What are the two types of primary form?
- hepatocellular carcinoma
2. cholangiocarcinoma
What is Hepatocellular Carcinoma? (4)
- > 80% –> most common
- arises in heptocytes
- link to chronic liver disease eg Hep C and toxins
- advanced at dx
Why is Liver CA linked to chronic liver disease such as Hep C?
Hep C pose a high risk for liver CA b/c viral DNA gets incorporated into the hepatocellular DNA, causing a mutation of host cell’s gene
Mutations of genes is related to ____ ______ (2 examples of common mutated genes giving rise to CA)
cell division
proto-oncogenes and tumor suppressor genes
What kind of toxins is related to liver CA? (1)
environmental toxins
Manifestations of Hepatocellular Carcinoma (2)
- insidious onset
2. masked by underlying disease
When is liver CA normally caught?
only caught at late stages
What is cholangiocarcinoma? (3)
- arises in epithelium of bile ducts (mutation of this tissue)
- linked to chronic inflm of epithelium (predispose to Liver CA)
- least common
What is bilharzia/schistosomiasis disease? (4)
Example: bilharzia/schistosomiasis disease
- present in tropical locations eg Afrika
- caused by flatworms called schistosome in contaminated water
- flatworm parasite has two hosts: humans and freshwater snails
- parasites penetrate the skin to get in host
How does Bilharzia/Schistocomiasis link to chronic inflm of the epithelium? How can it be eradicated?
In the dominant stage, a cyst is formed and deposits in liver and then biliary ducts–> if induced for years it predispose to liver CA
drugs
What is a hepatic adenoma? Which cells in the body does it affect? Who does it affect more? Age group?
- benign tumor
- appears in hepatocytes
- affect younger women of 20-30 y/o
Women who has Hepatic Adenoma are likely to be on _______ ____ b/c this tumor is supported _______. It is not a _________ malignancy.
contraceptive pills
hormonally
reproductive
Hepatic Adenoma is very ________ meaning lots of _______ ______Therefore there is a risk of ______ and _____. However, if this occurs, it is usually _______ _____ and the prognosis is good. It can be _______ removed.
vascularized (hypervascularized)
blood vessels
rupture and hemorrhaging
detected early
surgically
Secondary tumors are also known as ________ tumors.
metastatic
What 3 organs that commonly spread malignancy to the liver?
- lung
- colon
- breast
Manifestations of Liver CA (3)
- masked by liver disease (primary)
- anorexia, fever, weight loss, and abdominal pain
- hepatomegaly, ascites
Is using mnfst for diagnosis easy or hard?
hard
Which mnfst are specific to liver CA?
hepatomegaly and ascites
Which mnfst apply to several disorder of GIT and not helpful for dx?
anorexia, weight loss, abdominal pain, and fever`
Why is late diagnosis of Liver CA common?
mnfst of pre-existing chronic liver disease may mask the mnfst of CA leading to late diagnosis of CA
Treatment of Liver CA (3)
- poor prognosis (usually advanced @ dx)
- partial hepatectomy (partial removal of the liver) and may combined with chemo and radiation therapy
- supportive and palliative
If tx fails, the liver can shit down in __-__ months
2-6 months
T or F: Primary tumors are normally single tumors
T
T or F: spread is localized
F: it is extensive
